Edward is now 87 years old. He and his wife continue to live in the same small, crowded, damp council flat in Elephant and Castle - they don’t get out much. Their son, John, tries to visit most weeks.
John is now 60 years old, a labourer. He lives near his parents with his wife and they have 3 grown-up children, all of whom also still live in the area. John had always thought himself to be strong and fit, albeit with something of a beer gut, but over the last few months he has felt himself becoming too weak for heavy manual work. He drinks heavily (6 pints a day). He has always had a bit of a smoker’s cough and has given up smoking for the last 3 months, but the cough has got steadily worse. He coughs up yellowish sputum, which has recently become bloodstained.
His wife begs him to visit his GP when she notices that he has been coughing up blood but John refuses to go. He has had a bit of a fever for some weeks. Now John has developed drenching night sweats which soak the bed and his cough is accompanied by a sharp pain in his ribcage (pleuritic pain).